It’s a conversation that GM has become familiar with over the past couple of months. LML goes through her teddies “Monkey? Who gave me that?”, “Betty bear?”, “Stripy Cat”. She lists her soft toys as GM confirms the gifter .. “Mummy & daddy”, “Aunty J”, “we did”.

Today is slightly different .. “Who gave me this” she asks, holding up a white teddy that usually lives in a box under the bed. “That was a gift to Lolly from your birth parents LML.”

“Do I have one?” she asks.

“Of course you do, look the gifts from your BP’s are here, safe in this box”, GM pulls the box from under the bed. The girls have been playing with the clothes and toys inside it for weeks. “We keep them in here to keep them safe”.

Lolly goes to bed half an hour later snuggling up with the teddy her birth mum gave to her.

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GM thinks about how she thinks about LML, what she tells people. It’s very easy to tell the funny stories about the eggs in the garden centre, the streaking incident, Marmite hand prints … It’s not so easy for the mostly functional parents to talk about LML’s continuing daily assaults on her sister, and Lolly’s unsurprisingly aggressive response. There is no humour in LML’s reasonable resistance to her ADHD meds on school days. Friends don’t really want to hear about LML’s emerging understanding of her adopted status, and her sadness and longing for ‘the other mummy’.

GM realises that when she thinks about her daughter, she is often thinking about LML’s brain. About the missing and damaged neural pathways. She thinks about her tiny 2lb daughter laying alone in an incubator, having lost her twin, her mum and dad, her older brother who was already adopted. GM wept in a conference as Dr Rennes Marks described her daughters start in life and the impact that has had on her brain development.

All the excitement, all the bizarre or difficult or challenging behaviours, all the anxiety and meltdowns, all the sticky sloppy smearing, the hitting out and self harm … It is all made easier to cope with and manage due to the beautiful happy unselfconscious intrinsically joyful little girl that is LML. This child wakes up every day filled with joy and wonder. When CD or GM get home from work she shouts with love and excitement. She is excited by rainbows. She sings songs about how she is feeling when she is happy. GM has always felt that it is a great honour to have this amazing child in her life.

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GM arrives at the clinic with LML, who clearly remembers the environment from their previous visit. LML immediately heads for the water cooler. The waste tray is overflowing which surprises and fascinates LML. GM manages to distract her from the cooler for 5 minutes, until LML decides she wants to go to the toilet. GM shows LML to the toilet at which point she starts to shout like she is being slaughtered, so they return to the waiting room.

By this point GM has realised that she, indeed needs to pee. LML wants “to go wee” again so GM again takes her to the disabled toilet. This time, when she opens the door she maneuvers LML into the very spacious room. LML is shouting that she does not need to wee … actually she is shouting “NO! Nononononnooo!” GM explains that LML does not need to do anything, but “mummy needs a wee”. LML continues with her “no’s” and GM has to pee at the same time as preventing her daughter leaving the room while she is “doing the business”.

Soon after, they are called from the waiting room. They follow the nurse and psychologist to the (toyless) room. The marvelous nurse says “shall we find some toys?” to LML. She spends most of the rest of the session playing, throughout the whole of the CAMHS unit, with LML – whilst also managing to get her height and weight (BIG brownie points to Nurse Sula!).

GM and the psychologist discuss LML’s medical history and the immediate prospect of a prescription for stimulant medication. When LML pops into the room, the psych attempts a blood pressure reading, which is not successful, even on GM’s knee. On the next passing GM is ready and gathers LML onto her knee, holds her close (gently restraining her), and whispers to her, telling her what is happening, how long it will last, that she is OK and loved and it is OK .. there will be a squeeze, it’s OK, she is safe, its OK .. through this LML is tense but trusting. She is tense but holds her sooo tense body close to GM’s; she plants a hard kiss on GM’s cheek, then again and again. She moves her mothers head so that she can kiss her mouth. She squeezes her mums face and all the time GM reassures LML that “it is OK, I love you, you are safe” .. and then it is over and LML is off again.

The details of the month trial of ADHD medication is agreed, and the psychologist asks GM how she is feeling about it. GM manages to express some of her reservations and concerns (again), and talk about possible side effects.

LML is reshod and encouraged to tidy some of the toys that she has scattered throughout the room and building. The psychologist leaves to make out the prescription as GM, LML and nurse Sula go back to the waiting room. The psych comes back and hands the prescription to GM. Mother and daughter leave, call into the supermarket on the way home for bread and wine, and go home.

Aunty J has cooked dinner for the girls (she took Lolly to the playground from school, which involves another story). 10 minutes after she arrives home LML is sitting down to eat. Aunty J goes into the kitchen to get the girls a drink and finds GM sitting on a child’s chair crying into a tea towel. She strokes and pats her head as she sorts out the drinks and kisses her as she leaves the room. GM is very grateful.

The family have their dinner, and LML tries her best to eat a little spaghetti, sitting up on the sofa under her quilt. She doesn’t eat very much and it rapidly becomes clear that she is feeling poorlier. CD finds her in the hall, trying to remove her nappy, looking distressed and uncomfortable.

LML manages to walk up five steps before she stops, clutching her tummy, crying “wee wee mummy, wee wee.”. GM scoops her up and carries her the rest of the way, placing her on the floor when they get to the landing. GM goes and gets a nappy from the bedroom and starts to steer the ailing child towards the bathroom.

Suddenly all the signs are there … GM goes into catch mode … LML clutches at the arm in front of her and throws up into the cupped hands .. somehow GM manages to open the bathroom door and get to the loo without spilling a drop from her overflowing hands. A quick rinse of her hands and then a dash to the sick child to catch the next lot, which goes down the sink. GM manages to get the weeping child to the sink to finish off being sick.

LML is clear that she just wants to go to bed. By the time GM has got LML comfortable in bed,cleaned the sink, washed her hands (three times!) and got water and sick bowl, LML is sleeping soundly. GM sits for 5 minutes, looking at her beautiful, pale, poorly daughter, checking that she is breathing ok and then goes down stairs.

“Never, not in a million years, would I have anticipated,” she says to CD, ” .. there is absolutely no way .. I would have thought it completely impossibe that one of the things I would be really good at, as a parent, would be catching vomit!”

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The Mostly Functional Parents had both been looking forward to a whole week with no work, no school and no nursery. By the end of the week they are on their knees with exhaustion, frustration and disappointment.

They are pretty much in agreement that they ‘got it wrong’ – the week has been too unstructured and unplanned, too spontaneous, too wet and cold and just too too much for them all.

So, the next holidays the parents will remember a few rules

it’s ok to divide and rule

the weekly planner that is created for Little Miss Loud during term time will continue during the vacations – for every week

activities will be planned in advance – even vague ones like ‘an outing’

distance makes the heart grow fonder … time off nursery and play scheme do not need to coincide – indeed, it should be very well planned and executed if it happens at all when not actually ‘on a holiday’

going to bed earlier and drinking a bit less might not be what the beleaguered parents want to do, but it’s probably for the best.

So, the Mostly Functional Parents need to put away spontaneity and impulse for now and really really knuckle down to predictability, planning and routine.